Use of hormone (replacement) therapy in Europe

Hermann P.G. Schneider
Department of Obstetrics and Gynecology, University of Muenster, Germany

Recent surveys on the actual use of hormone (replacement) therapy or HT by women have to date only been conducted in the USA. Before the report from the Women’s Health Initiative (WHI) study, the Gallup Survey, conducted by Multi-sponsor Surveys, Inc., of the changing concerns about HT of consumers and physicians has shown that almost 90% of current HT users in the US were taking the medication for the relief of menopausal symptoms. Out of these, one-third were using it exclusively for the relief of menopausal symptoms and two-thirds were also taking it for associated health benefits. A large number (53%) of women using HT had continued to use it for more than 10 years, when interviewed in March 2002.

The findings from the WHI study questioned the use of hormone therapy for indications other than the relief of vasomotor symptoms and vulvovaginal atrophy, as well as the prevention of osteoporosis. In September 2002, 2 months after the publication of the WHI results, the number of US women stating that they were using HT only for symptom relief increased by one-fifth. The number of women also using it for the associated health benefits declined by the same amount.

No recent data on the use of HT in Europe are available and it is unclear to what extent the US findings can be applied to the situation in Europe. Thus, a survey on HT use in four European countries (Germany, Great Britain, France and Spain), including 8000 women aged 45–75 years, was initiated in February 2003 and was concluded in April 2003. The main objective of this survey was to obtain knowledge of the primary reasons for which European women use HT and, in this connection, to find out the mean duration of HT treatment in Europe. Furthermore, the survey focused on the main menopausal complaints from which women suffer and how the severity of these symptoms influences attitudes toward the use of HT. Since the survey was started 7 months after the publication of the WHI results, it also investigated the number of treatment changes (e.g. change of product or treatment schedule) and withdrawals in these four European countries with respect to the WHI results. Specific analyses will be performed by country and by user type.